eMedicine Specialties > Dermatology > Diseases of the Dermis

Atrophoderma of Pasini and Pierini: Treatment & Medication

Author: Anne Laumann, MB, ChB, MRCP(UK), FAAD, Associate Professor, Department of Dermatology, Feinberg School of Medicine, Northwestern University
Coauthor(s): Neelam Vashi, MD, Northwestern University, Feinberg School of Medicine
Contributor Information and Disclosures

Updated: Feb 9, 2009

Treatment

Medical Care

  • No treatment is consistently effective, but some patients respond to topical corticosteroids, antibiotics, or antimalarials.
  • Results of medical treatment with antibiotics have been inconclusive. In patients with new early-stage idiopathic atrophoderma of Pasini and Pierini, especially those with a positive B burgdorferi antibody titer, the standard recommended therapy for Lyme disease is suggested. A retrospective evaluation of 25 patients treated with oral penicillin (2 million IU/d) or oral tetracycline (500 mg 3 times/d) for 2-3 weeks showed clinical improvement with no new active lesions in 20 patients. The same study also showed no progressive disease in 4 of 6 patients who did not receive treatment.
  • Anecdotal reports have describe beneficial treatment with the use of hydroxychloroquine11 and potassium aminobenzoate.

Surgical Care

  • Surgical treatment has generally not been helpful in improving the appearance of the atrophied skin.
  • Arpey et al12 showed the Q-switched alexandrite laser (755 nm) to be effective in diminishing the hyperpigmentation by 50% after 3 treatments in one case. The improvement was suggested to be caused by reduction of the number, size, and volume of melanosomes.

More on Atrophoderma of Pasini and Pierini

Overview: Atrophoderma of Pasini and Pierini
Differential Diagnoses & Workup: Atrophoderma of Pasini and Pierini
Treatment & Medication: Atrophoderma of Pasini and Pierini
Follow-up: Atrophoderma of Pasini and Pierini
Multimedia: Atrophoderma of Pasini and Pierini
References
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References

  1. Pasini A. Atrofodermia idiopatica progressiva. G Ital Dermatol. 1923;58:785.

  2. Pierini L, Vivoli D. Atrofodermia progressiva (Pasini). G Ital Dermatol. 1936;77:403-09.

  3. Canizares O, Sachs PM, Jaimovich L, Torres VM. Idiopathic atrophoderma of Pasini and Pierini. AMA Arch Derm. Jan 1958;77(1):42-58; discussion 58-60. [Medline].

  4. Yokoyama Y, Akimoto S, Ishikawa O. Disaccharide analysis of skin glycosaminoglycans in atrophoderma of Pasini and Pierini. Clin Exp Dermatol. Jul 2000;25(5):436-40. [Medline].

  5. Kim SK, Rhee Sh, Kim YC, Lee ES, Kang HY. Congenital atrophoderma of Pasini and Pierini. J Korean Med Sci. Feb 2006;21(1):169-71. [Medline].

  6. Saleh Z, Abbas O, Dahdah MJ, Kibbi AG, Zaynoun S, Ghosn S. Atrophoderma of Pasini and Pierini: a clinical and histopathological study. J Cutan Pathol. Dec 2008;35(12):1108-14. [Medline].

  7. Miteva L, Kadurina M. Unilateral idiopathic atrophoderma of Pasini and Pierini. Int J Dermatol. Nov 2006;45(11):1391-3. [Medline].

  8. Buechner SA, Rufli T. Atrophoderma of Pasini and Pierini. Clinical and histopathologic findings and antibodies to Borrelia burgdorferi in thirty-four patients. J Am Acad Dermatol. Mar 1994;30(3):441-6. [Medline].

  9. Abe I, Ochiai T, Kawamura A, Muto R, Hirano Y, Ogawa M. Progressive idiopathic atrophoderma of Pasini and Pierini: the evaluation of cutaneous atrophy by 13-MHz B-mode ultrasound scanning method. Clin Exp Dermatol. May 2006;31(3):462-4. [Medline].

  10. Kernohan NM, Stankler L, Sewell HF. Atrophoderma of Pasini and Pierini. An immunopathologic case study. Am J Clin Pathol. Jan 1992;97(1):63-8. [Medline].

  11. Carter JD, Valeriano J, Vasey FB. Hydroxychloroquine as a treatment for atrophoderma of Pasini and Pierini. Int J Dermatol. Oct 2006;45(10):1255-6. [Medline].

  12. Arpey CJ, Patel DS, Stone MS, Qiang-Shao J, Moore KC. Treatment of atrophoderma of Pasini and Pierini-associated hyperpigmentation with the Q-switched alexandrite laser: a clinical, histologic, and ultrastructural appraisal. Lasers Surg Med. 2000;27(3):206-12. [Medline].

  13. Aberer E, Kollegger H, Kristoferitsch W, Stanek G. Neuroborreliosis in morphea and lichen sclerosus et atrophicus. J Am Acad Dermatol. Nov 1988;19(5 Pt 1):820-5. [Medline].

  14. Berman A, Berman GD, Winkelmann RK. Atrophoderma (Pasini-Pierini). Findings on direct immunofluorescent, monoclonal antibody, and ultrastructural studies. Int J Dermatol. Sep 1988;27(7):487-90. [Medline].

  15. Browne C, Fisher BK. Atrophoderma of moulin with preceding inflammation. Int J Dermatol. Nov 2000;39(11):850-2.

  16. Buechner SA, Rufli T. Progressive Idiopathic Atrophoderma of Pasini and Pierini-a Borrelia disease. Zentralbl Bakt Med Microbiol Hyg Suppl. 1989;18:1164-71.

  17. Buechner SA, Winkelmann RK, Lautenschlager S, Gilli L, Rufli T. Localized scleroderma associated with Borrelia burgdorferi infection. Clinical, histologic, and immunohistochemical observations. J Am Acad Dermatol. Aug 1993;29(2 Pt 1):190-6. [Medline].

  18. Franck JM, MacFarlane D, Silvers DN, Katz BE, Newhouse J. Atrophoderma of Pasini and Pierini: atrophy of dermis or subcutis?. J Am Acad Dermatol. Jan 1995;32(1):122-3. [Medline].

  19. Heymann WR. Coexistent lichen sclerosus et atrophicus and atrophoderma of Pasini and Pierini. Int J Dermatol. Feb 1994;33(2):133-4. [Medline].

  20. Jablonska S, Blaszczyk M. Is superficial morphea synonymous with atrophoderma Pasini-Pierini?. J Am Acad Dermatol. Jun 2004;50(6):979-80; author reply 980. [Medline].

  21. Jeanselme E, Burnier R. Sclerodermie en plaques avec dyschromie pigmentaire symmetrique. Bull Soc Fr Dermatol Syph. 1926;33:704-06.

  22. Kencka D, Blaszczyk M, Jablonska S. Atrophoderma Pasini-Pierini is a primary atrophic abortive morphea. Dermatology. 1995;190(3):203-6. [Medline].

  23. Murphy PK. Concomitant unilateral idiopathic atrophoderma of Pasini and Pierini and morphea (case report of IAPP in a black man). Int J Dermatol. 1940;29:281-3.

  24. Per M. Ein Fall von Sclerodermie superficiallis circumscripta en plaques. Venerol (Russ). 1926;4:578-83.

  25. Per M. Oberflachliche, circumscripta Sclerodermie. Handbuch. 1931;8:893.

  26. Pullara TJ, Lober CW, Fenske NA. Idiopathic atrophoderma of Pasini and Pierini. Int J Dermatol. Dec 1984;23(10):643-5. [Medline].

  27. Stainislaw AB, Theo R. Atrophoderma of Pasini and Pierini. J Am Acad Dermatol. 1994;30:441-6.

  28. Wakelin SH, James MP. Zosteriform atrophoderma of Pasini and Pierini. Clin Exp Dermatol. May 1995;20(3):244-6. [Medline].

  29. Wielowieyska-Szybinska D, Wojas-Pelc A, Dyduch G, Zawisz A. [Type I and II collagens and mast cells expression in the skin lesions from the patients with localized scleroderma]. Przegl Lek. 2008;65(4):161-5. [Medline].

  30. Wojas-Pelc A, Wielowieyska-Szybinska D, Kieltyka A. [Presence of the antinuclear antibodies and antibodies to Borrelia burgdorferi among patients with morphea en plaque, deep linear scleroderma and atrophoderma Pasini-Pierini]. Przegl Lek. 2002;59(11):898-902. [Medline].

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Further Reading

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Keywords

idiopathic atrophoderma of Pasini and Pierini, IAPP, atrophodermia idiopathica progressiva, progressive idiopathic atrophoderma, scleroderma, morphea, lichen sclerosus et atrophicus, B burgdorferi, Borrelia burgdorferi

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Contributor Information and Disclosures

Author

Anne Laumann, MB, ChB, MRCP(UK), FAAD, Associate Professor, Department of Dermatology, Feinberg School of Medicine, Northwestern University
Anne Laumann, MB, ChB, MRCP(UK), FAAD is a member of the following medical societies: American Academy of Dermatology, Association of Professors of Dermatology, Chicago Dermatological Society, Chicago Medical Society, Illinois Dermatological Society, Illinois State Medical Society, Illinois State Medical Society, Medical Dermatology Society, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

Coauthor(s)

Neelam Vashi, MD, Northwestern University, Feinberg School of Medicine
Neelam Vashi, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Physicians of Indian Origin, American Medical Association, American Medical Student Association/Foundation, and Indian American Medical Association
Disclosure: Nothing to disclose.

Medical Editor

Peter Fritsch, MD, Chair, Department of Dermatology and Venereology, University of Innsbruck, Austria
Peter Fritsch, MD is a member of the following medical societies: American Dermatological Association, International Society of Pediatric Dermatology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Lester F Libow, MD, Dermatopathologist, South Texas Dermatopathology Laboratory
Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association
Disclosure: Nothing to disclose.

CME Editor

Glen H Crawford, MD, Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital
Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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